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The CoVID-TE risk assessment model for venous thromboembolism in hospitalized patients with cancer and COVID-19.
Li, Ang; Kuderer, Nicole M; Hsu, Chih-Yuan; Shyr, Yu; Warner, Jeremy L; Shah, Dimpy P; Kumar, Vaibhav; Shah, Surbhi; Kulkarni, Amit A; Fu, Julie; Gulati, Shuchi; Zon, Rebecca L; Li, Monica; Desai, Aakash; Egan, Pamela C; Bakouny, Ziad; Kc, Devendra; Hwang, Clara; Akpan, Imo J; McKay, Rana R; Girard, Jennifer; Schmidt, Andrew L; Halmos, Balazs; Thompson, Michael A; Patel, Jaymin M; Pennell, Nathan A; Peters, Solange; Elshoury, Amro; de Lima Lopes, Gilbero; Stover, Daniel G; Grivas, Petros; Rini, Brian I; Painter, Corrie A; Mishra, Sanjay; Connors, Jean M; Lyman, Gary H; Rosovsky, Rachel P.
Afiliación
  • Li A; Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas, USA.
  • Kuderer NM; Advanced Cancer Research Group, Seattle, Washington, USA.
  • Hsu CY; Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, USA.
  • Shyr Y; Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, USA.
  • Warner JL; Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, USA.
  • Shah DP; Department of Medicine, Division of Hematology/Oncology, Vanderbilt University, Nashville, Tennessee, USA.
  • Kumar V; Mays Cancer Center at UT Health San Antonio MD Anderson Cancer Center, San Antonio, Texas, USA.
  • Shah S; Section of Hematology-Oncology, University of North Carolina, Chapel Hill, North Carolina, USA.
  • Kulkarni AA; Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, Minnesota, USA.
  • Fu J; Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, Minnesota, USA.
  • Gulati S; Hematology Oncology, Tufts Medical Center Cancer Center, Boston & Stoneham, Massachusetts, USA.
  • Zon RL; Division of Hematology/Oncology, University of Cincinnati, Cincinnati, Ohio, USA.
  • Li M; Division of Hematology, Brigham and Women's Hospital Boston, Boston, Massachusetts, USA.
  • Desai A; School of Medicine, Baylor College of Medicine, Houston, Texas, USA.
  • Egan PC; Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Bakouny Z; Brown University and Lifespan Cancer Institute, Providence, Rhode Island, USA.
  • Kc D; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
  • Hwang C; Hartford HealthCare Cancer Institute, Hartford, Connecticutt, USA.
  • Akpan IJ; Henry Ford Cancer Institute, Henry Ford Hospital, Detroit, Michigan, USA.
  • McKay RR; Herbert Irving Comprehensive Cancer Center at Columbia University, New York, New York, USA.
  • Girard J; Moores Cancer Center at the University of California, San Diego, California, USA.
  • Schmidt AL; University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA.
  • Halmos B; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
  • Thompson MA; Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA.
  • Patel JM; Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisconsin, USA.
  • Pennell NA; Beth Israel Deaconess Medical Center (BIDMC), Boston, Massachusetts, USA.
  • Peters S; Cleveland Clinic, Cleveland, Ohio, USA.
  • Elshoury A; Lausanne University Hospital, Lausanne, Switzerland.
  • de Lima Lopes G; Leukemia Service, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.
  • Stover DG; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.
  • Grivas P; Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA.
  • Rini BI; University of Washington, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, Seattle, Washington, USA.
  • Painter CA; Department of Medicine, Division of Hematology/Oncology, Vanderbilt University, Nashville, Tennessee, USA.
  • Mishra S; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.
  • Connors JM; Department of Medicine, Division of Hematology/Oncology, Vanderbilt University, Nashville, Tennessee, USA.
  • Lyman GH; Division of Hematology, Brigham and Women's Hospital Boston, Boston, Massachusetts, USA.
  • Rosovsky RP; University of Washington, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, Seattle, Washington, USA.
J Thromb Haemost ; 19(10): 2522-2532, 2021 10.
Article en En | MEDLINE | ID: mdl-34260813
BACKGROUND: Hospitalized patients with COVID-19 have increased risks of venous (VTE) and arterial thromboembolism (ATE). Active cancer diagnosis and treatment are well-known risk factors; however, a risk assessment model (RAM) for VTE in patients with both cancer and COVID-19 is lacking. OBJECTIVES: To assess the incidence of and risk factors for thrombosis in hospitalized patients with cancer and COVID-19. METHODS: Among patients with cancer in the COVID-19 and Cancer Consortium registry (CCC19) cohort study, we assessed the incidence of VTE and ATE within 90 days of COVID-19-associated hospitalization. A multivariable logistic regression model specifically for VTE was built using a priori determined clinical risk factors. A simplified RAM was derived and internally validated using bootstrap. RESULTS: From March 17, 2020 to November 30, 2020, 2804 hospitalized patients were analyzed. The incidence of VTE and ATE was 7.6% and 3.9%, respectively. The incidence of VTE, but not ATE, was higher in patients receiving recent anti-cancer therapy. A simplified RAM for VTE was derived and named CoVID-TE (Cancer subtype high to very-high risk by original Khorana score +1, VTE history +2, ICU admission +2, D-dimer elevation +1, recent systemic anti-cancer Therapy +1, and non-Hispanic Ethnicity +1). The RAM stratified patients into two cohorts (low-risk, 0-2 points, n = 1423 vs. high-risk, 3+ points, n = 1034) where VTE occurred in 4.1% low-risk and 11.3% high-risk patients (c statistic 0.67, 95% confidence interval 0.63-0.71). The RAM performed similarly well in subgroups of patients not on anticoagulant prior to admission and moderately ill patients not requiring direct ICU admission. CONCLUSIONS: Hospitalized patients with cancer and COVID-19 have elevated thrombotic risks. The CoVID-TE RAM for VTE prediction may help real-time data-driven decisions in this vulnerable population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tromboembolia Venosa / COVID-19 / Neoplasias Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Thromb Haemost Asunto de la revista: HEMATOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tromboembolia Venosa / COVID-19 / Neoplasias Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Thromb Haemost Asunto de la revista: HEMATOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido